#Nonalcoholic Fatty Liver Disease (NAFLD) and Nonalcoholic Steatohepatitis (NASH)
The difference between NAFLD and NASH.
“About 30% of the U.S. population has NAFLD and 5% has NASH. These rates are even higher in people with diabetes or obesity. About 2/3 rds of patients over 50 years who have diabetes or obesity are thought to have NASH. Of those who develop NASH, 20% or more will develop cirrhosis, and 1% to 5% will develop hepatocellular carcinoma.”
-Dx: Liver ultrasonography is more sensitive to diagnose NAFLD than hepatic function testing which may have normal results in persons with NAFLD.
-Liver biopsy is the preferred diagnostic test, but is invasive and has associated risk. Thus, it is limited to select high-risk patients. Clinical scoring systems using laboratory data and demographic information are being used to quantify the risk of NASH to determine who may benefit from biopsy
-Tx: Lifestyle modification is the first-line therapy. Weight loss may decrease steatosis, although results are inconsistent. Bariatric surgery may support weight loss and potentially decrease steatosis, but it is not a recommended treatment.
Sources
http://www.aafp.org/afp/2016/1215/p980.html
https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash